Nick right before going into top surgery in Calgary, Alberta, Oct 2018

Top surgery was the moment in my life that I looked forward to more than any other. It was the anchor that held me from floating away in the depths of my despair. The promise of being able to take a full breath once again, without the pressure of a binder on my ribs, rubbing me raw, literally and figuratively was enough to keep me grounded here on this earth. It was one of the most important milestones of my life and it is also the one I felt the least prepared for. Grow and birth a human from within my own body? No problem! I was prepared for that. I had seen it my whole life.

I was not prepared for my top surgery. I had only seen what social media allowed me to see as I watched from the outside looking in.

Within the transgender community there is this feeling like we can’t say anything other than glowing reviews about our surgeries because the outside world will try to use those hardships against us, to invalidate our truths.

And so I didn’t know what to expect, and felt unequipped to care for myself.

Nick’s friend, an ER nurse, removing is drains at home, on day 7 post op.

When asking the nurses questions upon discharge it was clear that they didn’t know how to care for my gender affirming top surgery either. They knew how to care for women identified folks who had a mastectomy for other reasons than wanting a more stereotypical male appearance. They didn’t know if I should or shouldn’t continue to bind my chest, and for how long? Should I use cold compressions? Wait when do I take the drugs again? What are they for? How do I get my drains out? It was all foggy. All too much.

And so I went home groggy but happy!! Because they were finally gone. I was in pain and nauseous but I was free of a deep ache in my body for the first time in decades.

Was the recovery harder than it should have been? Yes.

Would knowing more have made it easier? You bet. So 3 years post op from my gender affirming top surgery here is my look back at

what I wish I had known before having Double Incision top surgery

BE PREPARED

Every surgeon is different. They all have different thoughts on binding, and drains, and all sorts of things. Mix that with the fact that every body is different and “boom”, no two top surgeons or surgeries are alike.

Meaning you’re going to have to ask your surgeon for specifics on how to care for yourself post surgery.

Will you use a surgical binder? Will they provide it or will you? If you will, what binder do they recommend? (This is my favourite post top surgery binder) Do they use drains aka blood grenades? If so, when are they removed? How do you book that appointment? Can you fill your Rx ahead of time? Are there any other appointments you will need to schedule, or materials you will need to purchase? If something goes wrong, what do you do?

This also means you need to ask for help with meals, driving, and emptying your drains. Finding help before surgery is very much recommended.

2. PILLOWS PILLOWS + MORE PILLOWS

I know what you’re thinking, really I need to get more/special pillows? What is that going to do? The answer, EVERYTHING! In my experience it felt like I was hit by a truck. And somehow my ass hurt from sitting/lying in the same position so much. I used basically dozens of pillows to prop myself up, and change positions. Yes, this is just as nerdy as it sounds. But it gets better.

Enter the Husband Backrest Pillow. I don’t know why amazon calls it that. But these backrest pillows with arms. They are a lifesaver. They just made everything more comfortable.

Side Note: As trans folks we have often spent our whole lives hiding our chest, with terrible posture has officially caught up to all of us! This is your chance you set your new posture straight! Don’t let yourself heal all hunched over like I did.

3. BE SO GENTLE

You’ve waited what feels like eternity for this! You finally have a body that feels closer to your own. So of course you want to take it out for a spin. Lift some weights, try out sexy times with a lover, and rock one of those cool kid muscle shirts. You know like the tank tops, that aren’t really tank tops? Obviously these are the first things on your mind, and you are going to have the chance to do them all. But you can’t do it all at once. Because you just had major surgery! Sometimes we forget how big of a deal this is. Be gentle with yourself, emotionally and physically.

4. BREATHE DEEPLY...THEN DEEPER

After I had surgery and had already recovered terribly for a couple of weeks, a friend of mine popped by to bring some food and shared her expertise as a physical therapist with me.

The trick to reducing scar tissue, and fascia problems and increasing mobility, and blood flow is Belly Breathing, also known as diaphragmatic breathing.

Diaphragmatic breathing is basically breathing slowly and deeply causing your chest, and belly to expand, allowing your ribcage, muscles and fascia mobile and good blood flow moving throughout these muscles.

If I could do one thing differently I would have started my deep belly breathing and new posture habits right away. I think it would have made a huge difference in my recovery. g.

5. SET TIMERS, TAKE NOTES.

There’s nothing like waking up at 4 am in excruciating pain because you missed your 2am dose of meds. The clawing your way back from the dark side isn’t worth an extra uninterrupted hour of sleep. I promise! The drugs work best when you take them exactly like the doctors tell you to. Wild right!?

BONUS ADVICE-

Trust your body. Trust your instincts. Advocate for yourself, and bring someone else with you who can advocate for you when you can’t. In my experience I wasn’t able to ask the right questions, because I wasn’t coherent enough after surgery. Throughout the day of my surgeryI wasn’t able to correct hospital staff, nurses, and administrators on my name and pronouns because it was too mentally exhausting. Having Katherine and my chosen sister Daniella with us was everything.

IT MIGHT NOT GO PERFECTLY… BUT IT WILL HAPPEN, HANG IN THERE.

In the end, no matter how much you prepare, or how long you have to wait, your surgery day will come. And like mine, it might not go perfectly, or even close to what you hoped for, but whatever happens, you’ll be one step closer to your physical body feeling more aligned with your spiritual one.

5 THINGS I WISH I KNEW BEFORE HAVING TOP SURGERY

what I wish I had known before having Double Incision top surgery